1. COVID-19 Testing: Will continue to be covered, in-network only, and the applicable copay will be applied. 2. Over-the-Counter COVID-19 Testing: Will continue to be covered, in-network only, 1 test kit per month per individual at the following pharmacies: Walgreens (including Duane Reade), Rite Aid (including Bartell Drugs), and the Optum Store; a $5 copay will be applied. 3. Vaccines: Will continue to be covered in-network only, with no cost share. 4. Antivirals: Will continue to be covered under the prescription drug benefit plan; a $35 copay will be applied.
Click here to view the Updated DOL Notice for NSA
This Plan is required to provide certain information on a public website pursuant to the Federal Transparency in Coverage Final Rule published in the Federal Register on November 12, 2020.
This Rule is intended to make information about the prices charged for health care available to the general public, particularly researchers. These experts can use pricing information from this Plan and others to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending.
The Rule requires that the Plan post links to machine-readable files that contain information about the price of health care services. A machine-readable file is written in computer code and is an extremely large file. It is not intended to be downloaded or read by participants but to be used in research studies. The files do not contain Protected Health Information (PHI) about you or your family.
Links on this website provide machine-readable files for the Plan’s in-network negotiated rate and historical allowed amounts for out-of-network charges. The files attached to the links are maintained by the Plan’s third party administrator, Empire Blue Cross Blue Shield. BCBS will update the file attached to the links automatically each month.
If you have any questions about the Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f
https://www.empireblue.com/machine-readable-file/search
Click here to view the No Suprise Act
Commencing January 15th, for those who have current Active Medical coverage, OptumRx will provide free of charge EU approved COVID-19 test kits filled at any Rite Aid Pharmacy. To support manual claim processing as part of a standard solution, test kits not purchased through the Retail Preferred Network (Rite-Aid) will be reimbursed up to $12 per test/unit (it would need to be the ones on the list below that have been approved for Emergency Use (EU)). For your convenience, click on the link to find your closet Rite Aid near you. https://www.riteaid.com/locations/search.html
In the event there are no Rite-Aid pharmacies in close proximity, there are various ways you can submit the receipts. You can log into your account by using your computer and completing the form and uploading your receipts, mailing in a paperwork reimbursement form, or clicking on the link below with your mobile device and simply upload a picture of your receipt after completing the form. https://covidtest.optumrx.com/covid-test-reimbursement
You can also access free testing in the community. A list of community-based testing sites can be found here https://www.hhs.gov/coronavirus/community-based-testing-sites/index.html Remember COVID-19 tests are also available without cost-sharing to covered individuals when administered by a health care provider such as a nurse, doctor, or pharmacist, without limitation.
Dear Brothers, Sisters and Participants:
On behalf of the Board of Trustees of the Local 14-14B Annuity Fund, I hope that you and your families are safe and healthy. On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief and Economic Security Act (“CARES Act”) which provides relief and allows Plans, such as the Local 14 Annuity Fund, to provide a new form of distribution to eligible participants affected by the coronavirus pandemic together with a special loan provision and a waiver of Required Minimum Distributions for 2020.
Earlier today, the Board of Trustees voted to amend the Local 14 Annuity Fund’s Plan Document to provide affected participants with greater access to their individual annuity accounts in accordance with the CARES Act. The amendments to the Local 14 Annuity Fund are as follows:
• In-Service Distributions - Through December 31, 2020, a participant is allowed to take up to $100,000 from his/her individual annuity account as a “coronavirus-related distribution” if the participant has: (1) tested positive for COVID-19; (2) a spouse or beneficiary who tested positive for COVID-19; or (3) experienced one or more of a wide range of adverse financial consequences including being quarantined, furloughed or laid-off, having a reduction in work hours, or being unable to work due to a lack of child care as a result of the COVID-19 pandemic. As provided for by the CARES Act, the federal government is waiving its collection of the otherwise required 10% early withdrawal penalty, and you may pay the income tax due on the distribution over 3 years as well as repay the amount of the distribution within 3 years. The Fund Office is working with Prudential Retirement Services to update the application and administrative procedures required to effectuate this in-service distribution option.
• Plan Loans - Any participant who has (1) tested positive for COVID-19; (2) a spouse or beneficiary who tested positive for COVID-19; or (3) experienced one or more of a wide range of adverse financial consequences including being quarantined, furloughed or laid-off, having a reduction in work hours, or being unable to work due to a lack of child care as a result of the COVID-19 pandemic, is now eligible to take a loan through September 23, 2020 in an amount equal to the greater of $100,000 or 100% of the participant’s nonforfeitable accrued benefit (the amount of the loan is reduced by the outstanding balance of any existing loans). In addition, any participant with a loan between March 27, 2020 and December 31, 2020 may delay for 1 year any loan repayments due during this period. The Fund Office is working with Prudential Retirement Services to update the application and administrative procedures required to implement this new loan option as well as any directive from a participant to delay loan payments due through the end of the year.
• Requirement Minimum Distribution (“RMD”) - Participants may waive the RMD they would otherwise be required to take in 2020 because they attained age 70 ½ in 2019 (unless they received a RMD in 2019) or attained age 70 ½ in earlier years. A participant must affirmatively effectuate this waiver by providing written notice to the Fund Office. The Fund Office is in the process of drafting a waiver form to be used by affected participants.
If you have any questions, please contact the Fund Office and please stay safe and well during these trying times.
Fraternally yours,
Edwin L Christian
Business Manager & Member
of the Board of Trustees
Combating heart and lung disease should be everyone's top priority. As we ponder over who should be liable for our health, the Board of Trustees has given authorization for IUOE local 14-14b to enter into an agreement with Inner Imaging that will encourage our participants to take part in a health screening exam. These scans will help identify the early stage of disease. The scans are available to all active eligible participants and spouses 35 and over once every 5 years. Spouses with primary health coverage will be eligible upon receiving a denial from your health insurance carrier. Start your day to a healthier path by calling Inner Imaging to schedule an appointment.
Click on the link for location www.innerimagingnyc.com.